覆膜支架腔内隔绝术治疗StanfordB型主动脉夹层的临床分析  

Clinical Analysis of Stent Endovascular Graft Exclusion for Stanford Type B Aortic Dissection

作　　者：刘建平[1] 何元军[2] 张永恒[1] 周海宁[1] 马蓉[1] 

机构地区：[1]遂宁市中心医院胸心外科,四川遂宁629000 [2]遂宁市第一人民医院心内科,四川遂宁629000

出　　处：《中国医药指南》2013年第5期19-21,共3页Guide of China Medicine

摘　　要：目的探讨应用覆膜支架腔内隔绝术治疗Stanford B型主动脉夹层的临床方法、临床疗效,探讨扩大Stanford B型主动脉夹层累及左锁骨下动脉、左颈总动脉和头臂动脉时的介入治疗适应证。方法回顾性分析2008年1月至2012年5月我院收治的37例Stanford B型主动脉夹层并行介入性腔内隔绝术治疗的患者的临床资料,着重分析手术方法、手术结果、并发症及术后随访等情况。结果 37例手术均成功,其中34例放置普通主动脉覆膜支架;1例利用"开窗"技术放置覆膜支架封堵夹层破口;2例以"烟囱"支架重建左颈总动脉的血流并放置主动脉覆膜支架。随访中死亡1例,所有患者均无支架移位、断裂、塌陷、术后截瘫及脑血管意外的发生。结论覆膜支架腔内隔绝术治疗Stanford B型主动脉夹层具有良好前景,采取不同方法延长近端锚定区可扩大适应证。Objective To explore the clinical application and the clinical efficacy of stent endovascular graft exclusion for Stanford type B aortic dissection,and to assess the feasibility of expanding the indications of interventional treatment for complex Stanford type B aortic dissection.Methods From January 2008 to May 2012,the clinical data of 37 Stanford type B aortic dissection patients who adopted the therapy of stent endovascular graft exclusion were analyzed retrospectively.To analyze the surgical methods,surgical outcomes,complications and postoperative follow-up of stent endovascular graft exclusion for Stanford type B aortic dissection in detail.Results 37 cases were operated successfully.34 cases were placed ordinary aortic stent-graft;1 patient were managed by the ＂window technology＂ to close mezzanine break;2 patients were managed by the ＂chimney grafts technology＂ to restore the left common carotid artery blood flow.One case died in the course of follow-up survey.There were not complications such as the displacement,fracture,deformation of the stent grafts,paraplegia and cerebrovascular accident after endovascular therapy.Conclusion The stent endovascular graft exclusion is a safe and good therapy for Stanford type B aortic dissection.Taking different approaches which can extend the proximal landing zone can expand the indications of stent endovascular graft exclusion.

关 键 词：腔内隔绝术 STANFORD B型主动脉夹层 覆膜支架 

分 类 号：R543.1[医药卫生—心血管疾病]